Peritoneal Dialysis in Elderly Patients: Clinical Experience

2005 ◽  
Vol 25 (3_suppl) ◽  
pp. 88-91 ◽  
Author(s):  
Edwina A. Brown
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Clinical Outcome ◽  
Elderly Patients ◽  
Older Patients ◽  
Younger Patients ◽  
The North ◽  
A Prospective Study ◽  
Better Than

Many older patients do not cope well with hemodialysis, yet the proportion of older patients on peritoneal dialysis (PD) is considerably lower than for younger patients. This is despite the fact that clinical outcome studies show that older patients cope as well as, if not better than, younger patients on PD. Furthermore, the North Thames Dialysis Study, a prospective study of patients ≥70 years old, has shown that survival, hospitalization, and quality of life were identical for patients on hemodialysis and patients on PD.

scholarly journals Older Patients Are Less Affected by Radiochemotherapeutic Treatment than Younger

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Max J. Weiling ◽  
Wencke Losensky ◽  
Katharina Wächter ◽  
Teresa Schilling ◽  
Fabian Frank ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Cancer Patients ◽  
Older Patients ◽  
Normative Data ◽  
Age Groups ◽  
German Population ◽  
Younger Patients ◽  
Significant Difference

Purpose. The general assumption is that cancer therapy impairs the quality of life in elderly patients more than in younger ones. We were interested in the effects of radiochemotherapeutic treatment on the quality of life of elderly patients compared to younger patients and compared to normative data of a general German population. Methods and Materials. A total of 465 patients completed the EORTC QLQ-C30 questionnaire. Repetitive completion of the questionnaire over time led to 1407 datasets. Our patient cohort contained 197 (42.4%) patients with colorectal cancer followed by 109 (23.4%) patients with head and neck cancer, 43 (9.2%) patients with lung cancer, and 116 (25%) with other types of cancer. Patients were categorized into five age groups, the respective cut-offs being 40, 50, 60, and 70 years. Normative data were drawn from a population study of a general German population. Results. Functional scores and symptom scores were approximately stable between the different age groups. Our data does not suggest a significant difference between the investigated age groups. Advancing age evened out the differences between the normative data of the general German population and the cancer patients in 11 of 15 scores. Conclusions. The general belief about younger patients having fewer physical and psychological problems related to radiochemotherapy needs to be reconsidered. Overall resilience of older patients is apparently underestimated.

Age is not a contraindication to home-based dialysis - Quality-of-Life outcomes favour older patients on peritoneal dialysis regimes relative to younger patients

2014 ◽  
Vol 70 (8) ◽  
pp. 1902-1914 ◽  
Author(s):  
Konstadina Griva ◽  
Zhenli Yu ◽  
Sally Chan ◽  
Thanaletchumi Krisnasamy ◽  
Ruyani Bte Abu Yamin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Older Patients ◽  
Life Outcomes ◽  
Younger Patients ◽  
Quality Of Life Outcomes ◽  
Home Based

How to Address Barriers to Peritoneal Dialysis in the Elderly

2011 ◽  
Vol 31 (2_suppl) ◽  
pp. 83-85 ◽  
Author(s):  
Edwina A. Brown
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Cognitive Dysfunction ◽  
Older Patients ◽  
The Elderly ◽  
Dialysis Modality ◽  
Poor Vision ◽  
Younger Patients

Older patients on dialysis have unique needs and characteristics and their outcomes vary from that of their younger counterparts. Comparatively fewer will start or be maintained on peritoneal dialysis (PD) compared to younger patients, despite the fact that hemodialysis is often poorly tolerated. Barriers to PD for older patients include poor vision, frailty, cognitive dysfunction, accommodation issues, and a bias from renal teams that older patients cannot do PD. The development of assisted PD can overcome many of these barriers. The ability of older patients to use PD as their dialysis modality should not be determined by whether they live in an area where the nephrologist is a PD enthusiast. All patients should be given nonbiased information so they can choose the dialysis modality that gives them the best quality of life and suits their and their family's lifestyle.

Clinical outcomes and Quality of Life in Elderly Patients on Peritoneal Dialysis versus Hemodialysis

2002 ◽  
Vol 22 (4) ◽  
pp. 463-470 ◽  
Author(s):  
◽  
Susan A.C. Harris ◽  
Donna L. Lamping ◽  
Edwina A. Brown ◽  
Niculae Constantinovici
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Elderly Patients ◽  
Clinical Outcomes ◽  
Elderly People ◽  
Life Questionnaire ◽  
The North ◽  
Relative Risks ◽  
Sf 36

♦ Objective To compare clinical outcomes and quality of life (QOL) in elderly patients on peritoneal dialysis (PD) and hemodialysis (HD) in the North Thames Dialysis Study. ♦ Design A 12-month prospective cohort study. ♦ Setting Four hospital-based renal units in London, UK. ♦ Patients 174 patients that were 70 years or older at the start of dialysis, separated into two cohorts: 78 new patients (36 PD, 42 HD) that were recruited after 90 days of chronic dialysis; and 96 stock patients (42 PD, 54 HD) that were already on dialysis during the recruitment period. ♦ Main Outcome Measures 12-month survival and hospitalization rate, and QOL assessed at baseline and at 6 and 12 months by the SF-36 and the Symptoms/Problems scale of the Kidney Disease Quality of Life Questionnaire (KDQOL). ♦ Results Peritoneal dialysis and HD patients were similar for sociodemographic and clinical characteristics. Annual mortality and hospitalization rates in PD versus HD patients were 26.1 versus 26.4 deaths/100 person–years and 1.9 versus 2.0 admissions/person–year, respectively. Adjusted relative risks showed no effect of modality on clinical outcomes. Multiple linear regression analyses of QOL at baseline showed similar SF-36 scores between PD and HD patients, but higher KDQOL scores in PD patients (3.5 points higher, 95% confidence interval 0.3 – 6.6). There was, however, no effect of dialysis modality on QOL at 6 or 12 months. ♦ Conclusions Clinical outcomes and QOL are similar in elderly people on PD and HD. Peritoneal dialysis is a viable option for more than a carefully selected minority of elderly people requiring dialysis.

scholarly journals Kidney Transplant in an Old Woman-A Case Report and Review of the Literature

2015 ◽  
Vol 12 (1) ◽  
pp. 62-64
Author(s):  
Lidija Orlic ◽  
Ivana Mikolasevic ◽  
Branka Sladoje-Martinovic ◽  
Ivan Bubic and Sanjin Racki
Keyword(s):  
Quality Of Life ◽  
Renal Transplantation ◽  
Elderly Patients ◽  
End Stage Renal Disease ◽  
Older Patients ◽  
Review Of The Literature ◽  
Stage Renal Disease ◽  
End Stage ◽  
Esrd Patients

Abstract The number of elderly patients with chronic kidney disease (CKD) as well as those with end-stage renal disease (ESRD) are increasing worldwide. Renal transplantation is now the treatment of choice for all ESRD patients, including those that are aged 65 or over. Namely, there is a growing evidence that elderly patients, in the absence of contraindications, have better outcomes after renal transplantation than alternative forms of RRT. Although survival, quality of life and economic advantages have been shown after transplantation, renal transplantation is still infrequently offered to older patients. Hereby, we present a case of an old woman who was transplanted in 1994 when “senior” program was still not established and when kidney transplantation at this age was rarity in many countries. She lived 16 years and 8 months with a well-functioning graft and died at the age of 89.

Abstract 17469: Comparing the Effect of CRT Implantation on Quality of Life in Older Patients Compared With Younger Patients: Systematic Review and Meta-Analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Praveen Ponnamreddy ◽  
Saeed Juggan ◽  
Lauren Gilstrap
Keyword(s):  
Quality Of Life ◽  
Older Patients ◽  
Meta Analysis ◽  
Nyha Class ◽  
Age Group ◽  
Walk Test ◽  
Younger Patients ◽  
Six Minute Walk Test ◽  
Minute Walk

Background: CRT had been accepted as standard of care for patients with HFrEF who qualify for the therapy. The pivotal CRT trials enrolled patients significantly younger than the typical HFrEF patients seen in the community. Benefits of CRT in older HFrEF patients is largely unknown. We sought to evaluate the change in quality of life in older patients undergoing CRT in comparison to younger patients. Hypothesis: CRT implantation is associated with comparable improvements in quality of life in younger patients (age <70) and older patients (age 70 and above). Methods: PubMed, The Cochrane Library, Scopus, and Web of Science were queried for comparative effectiveness studies of CRT in older HFrEF patients. We gathered data for Quality of life measurements including improvement in NYHA class, MLHFQ, Six minute walk test. MLHFQ, Six minute walk test data was analyzed qualitatively as data was insufficient to impute Standard deviation for mean change. Changes in NYHA class was analyzed quantitatively. Random effects meta-analysis of improvement in NYHA class and relative risk (RR) is reported along with estimates of heterogeneity Results: Seven studies [n=2494 for younger group and n=1035 for older group] were included in changes in NYHA class meta-analysis. Older age group patients had similar improvement in NYHA class compared to younger age group patients. Relative risk 0.99 with 95%CI 0.93-1.06 (figure). Five studies reported Baseline and follow up MLHFQ scores for both the groups. All the five studies reported improvements in MLHFQ in both the groups. Three studies reported change in six minute walk test in meters before and after CRT implantation. All the studies reported improvement in six minute walk test both in younger and older group. Conclusions: People older than 70 years of age with heart failure with reduced ejection fraction who qualify for CRT derive similar benefits with improvement in quality of life compared to patients aged less than 70 years of age.

scholarly journals Tapentadol Prolonged Release for Severe Chronic Osteoarthritis Pain in the Elderly—A Subgroup Analysis of Routine Clinical Practice Data

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Andreas Schwittay ◽  
Melanie Sohns ◽  
Birgit Heckes ◽  
Christian Elling
Keyword(s):  
Quality Of Life ◽  
Clinical Practice ◽  
Elderly Patients ◽  
Subgroup Analysis ◽  
The Elderly ◽  
Routine Clinical Practice ◽  
Prolonged Release ◽  
Younger Patients ◽  
Quality Of Life Measures

Background. Tapentadol prolonged release (PR) has been shown effective and generally well tolerated in a broad range of chronic pain conditions. This subgroup analysis investigated its benefits for elderly patients with severe chronic osteoarthritis (OA) pain in routine clinical practice. Patients and Methods. Data of all patients with chronic OA pain were extracted from the database of a prospective, 3-month noninterventional tapentadol PR trial. The data of elderly OA patients (>65 years of age; n = 752) were compared with the data of younger OA patients (≤65 years; n = 282). Results. Almost all patients (elderly 98.7% and younger patients 99.3%) had received long-term analgesic medication prior to the start of tapentadol PR treatment but presented with severe pain accompanied by considerable impairments in sleep quality and quality of life measures. Tapentadol PR provided effective pain relief in both patient groups, with slightly better outcomes in younger patients. However, the mean baseline pain intensity of 7.1 (SD 1.5) was reduced by 3.8 points (p≤0.001), and sleep and quality of life measures had also markedly improved in the elderly: quality of sleep by 3 points, quality of life by 3.4 points, social activities by 3 points, and independence by 2.7 points (p≤0.001 for all measures; 11-point scale). At the end of observation, 68% of the elderly had clinically relevant pain reductions of at least 50% (vs baseline), and 87.9% attained either their intended pain reduction target and/or an additional individual treatment target (both predefined during baseline examination). Only 8.4% of the elderly experienced adverse drug reactions, most frequently nausea (2.7% of patients) and dizziness (1.5%). Conclusion. Tapentadol PR provided effective and well-tolerated treatment of severe chronic OA pain for elderly patients in routine clinical practice. The favorable tolerability profile in particular suggests tapentadol PR as a treatment option before classical strong opioids are considered.

scholarly journals Health-related quality of life and distress in elderly vs. younger patients with high-grade glioma—results of a multicenter study

2020 ◽  
Vol 28 (11) ◽  
pp. 5165-5175 ◽  
Author(s):  
Mirjam Renovanz ◽  
Anne-Katrin Hickmann ◽  
Minou Nadji-Ohl ◽  
Naureen Keric ◽  
Elke Weimann ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
High Grade Glioma ◽  
High Grade ◽  
Health Related Quality ◽  
Younger Patients ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related

Abstract Objective Half of all newly diagnosed patients with glioblastoma are > 65 years still with a poor prognosis. Preserving quality of life is of high importance. However, patient reported outcome (PRO) data in this patient group is rare. The aim was to compare health-related quality of life (HRQoL) and distress between elderly and younger patients with high-grade glioma (HGG). Methods We used baseline data of a prospective study where HGG patients were enrolled from 4 hospitals. Distress was measured using the distress thermometer (DT), HRQoL using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30) plus brain module (BN20). We compared distress and HRQoL by age (≥ 65 vs. < 65 years), gender, performance score, and time since diagnosis using multivariate linear and logistic regressions. Results A total of n = 93 (30%) out of n = 309 patients were ≥ 65 years (mean 70 years, range 65–86 years). Mean DT score of elderly patients (5.2, SD 2.6) was comparable with younger patients (4.9, SD 2.6). Elderly patients reported significantly lower global health (GHS, mean elderly vs. younger; 50.8 vs. 60.5, p = 0.003), worse physical (56.8 vs. 73.3, p < 0.001) and lower cognitive functioning (51.1 vs. 63.2, p = 0.002), worse fatigue (52.5 vs. 43.5, p = 0.042), and worse motor dysfunction (34.9 vs. 23.6, p = 0.030). KPS and not age was consistently associated with HRQoL. Conclusion Physical functioning was significantly reduced in the elderly compared with younger HGG patients, and at the same time, emotional functioning and DT scores were comparable. KPS shows a greater association with HRQoL than with calendric age in HGG patients reflecting the particular importance for adequate assessment of HRQoL and general condition in elderly patients.

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